Retrospective Analysis Of 198 Cases Of Advanced Hepatic Alveolar Echinococcosis

Objective: Retrospective analysis of the clinical case data of advanced HAE,from June 2013 to June 2018,in Qinghai University Affiliated Hospital,summed up the experience of clinical diagnosis and treatment.Method: To collect clinical data of patients with advanced HAE in Qinghai University Affiliated Hospital,from June 2013 to June 2018,and retrospective analysis the demographic characteristics,symptoms and signs,age,birthplace,laboratory and imaging examinations,treatment methods,efficacy and complications of patients with advanced HAE.Result: 1.A total of 198 cases of advanced HAE were collected.The average age at diagnosis was 39.34±12.01 years old,and the ratio of male to female was 1:1.54.Among the ethnic distribution,186(93.9%)were Tibetans,accounting for the vast majority;in the geographical distribution,153(77.3%)were in Guoluo,31(15.7%)in Yushu,and 7(3.5%)in Xining;The number of occupations was the highest among herders,146 cases(73.7%);2.Clinical manifestations included 109 cases of upper abdominal pain(55.1%),upper abdominal pain with skin mucosa yellow staining in 49 cases(24.7%),simple skin mucosa yellow staining in 31 cases(15.7%);Child-Paugh grade A grade There were 49 cases(24.7%),97 cases(49.0%),and 52 cases(26.3%).3.the lesion located in 137 cases(69.2%)of left and right liver,48 cases(24.2%)in right liver,108 cases(54.5%)have one lesion in liver,90 cases(45.5%)have more than 2 lesions;the organs and tissues most affected by the lesion were 51 cases(25.8%)of the diaphragm;the distant metastasis was mostly in the lungs,86 cases(43.4%).Distal metastasis may be associated with invasion of the inferior vena cava and portal vein in the liver(P<0.05).4.Patients with advanced HAE and obstructive jaundice treated with PTCD and ERCP,AST,ALT,TBil and other indicators were significantly lower than before treatment(P<0.05);Patients with liquefied cavity type advanced hepatic alveolar echinococcosis were treated with lesion puncture and drainage,and AST and ALT were slightly lower than before treatment(P<0.05).Conclusion:1.the lesion,which is the most across the left and right liver.The adjacent organs are mainly composed of diaphragm,and the distant metastasis is mostly in the lung.The distant metastasis may be related to the age of patients,the invasion of the inferior vena cava and portal vein.2.PTCD,ERCP treatment of advanced HAE with obstructive jaundice,can effectively improve liver function and reduce jaundice index.3.The treatment of liquefied cavity type advanced HAE by lesion puncture drainage can alleviate upper abdominal pain,improve liver function,and create conditions for follow-up treatment.